Provider Demographics
NPI:1386363398
Name:CANAVAN, RACHEL JEANNE (RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JEANNE
Last Name:CANAVAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SHEPHERDS WAY
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-7946
Mailing Address - Country:US
Mailing Address - Phone:513-545-0571
Mailing Address - Fax:
Practice Address - Street 1:409 SHEPHERDS WAY
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-7946
Practice Address - Country:US
Practice Address - Phone:513-545-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.381807163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse